With persistent advancement and development of organ transplantation technology in recent years, transplantation technologies for different organs have gradually matured at home and abroad. Since the first case of liver transplantation worldwide, liver transplantation has become an important treatment for acute liver failure and end-stage liver diseases, which has been routinely carried out in major transplantation centers. However, the existing shortage of donor liver is still severe across the globe. Meantime, the incidence of chronic hepatitis B is high in Asian countries, and the number of recipients awaiting liver transplantation is increasing. Most patients with acute and critical liver diseases fail to receive blood type-matched donor liver, lose the operation opportunity or even die because of the disease deterioration. Considering the donor-recipient imbalance caused by fewer donors than recipients, ABO-incompatible liver transplantation (ABOi-LT), as an effective strategy to expand the source of liver donors, brings new hope to the recipients awaiting liver transplantation. However, liver necrosis, intrahepatic biliary complications, ABO blood group antibody-mediated rejection (AMR), postoperative infection, kidney injury are prone to occur after ABOi-LT, among which AMR is the most threatening complication. Therefore, preventing the occurrence of AMR is the key to success of ABOi-LT. In this article, the latest research results of ABOi-LT and immunosuppression strategies were summarized in combination with relevant literature review at home and abroad, aiming to provide reference for the study of clinical liver transplantation.